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The stereotypical heroin addict may be just that, according to a study of continuing heroin users who either escaped dependency altogether or managed to live controlled, productive lives while dependent on heroin. Published December 16, the study from the Institute for Criminal Policy Research, Kings College, London, found there is a largely hidden population of people who use heroin without causing serious harm to themselves or others.

While most research on heroin users draws on populations in drug treatment or the clutches of the criminal justice system, this study's sample (51 in-depth interviewees and 123 people surveyed via the Internet) consisted almost entirely of people who were either working or studying, owned or rented their own homes, and had never been arrested. The users in this study also remained in good health and enjoyed full social lives, they reported.

Some respondents were long-term users but not addicted. They reported avoiding dependency by following "using rules" that limited the frequency with which they indulged. Those rules included not only avoiding everyday use, but also avoiding involvement in a "heroin scene, not injecting the drug, and not using if they couldn't afford it. Other respondents were addicted but used heroin in a controlled, stable fashion over long periods of time, limiting amount rather than frequency.

"Sustained heroin use does not inevitably lead to dependency, and that dependency will not always cause users significant problems -- particularly involvement in crime and personal degeneration," the study concluded. "We have demonstrated that, for some people, using heroin does not strip them of the ability to make conscious, rational and autonomous decisions about their drug use."

While conceding that they do not know how large the subset of controlled heroin users is among the heroin-using population, the study's authors nonetheless see policy implications in their findings. The notion of controlled use could be applied in drug treatment and harm reduction settings, encouraging users to see themselves less as addict victims and more as people in control of their own lives. It should also cause policymakers to rethink laws criminalizing drug possession, they authors suggested, although with little hope that will happen.